Using Health Care Funds to Support Employee CSAs and Food Education. Maren Beard Luther College, Decorah Iowa January 30, 2015

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Using Health Care Funds to Support Employee

CSAs and Food Education

Maren Beard

Luther College, Decorah Iowa January 30, 2015

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Roadmap

 Discovery Activity

 Luther CSA Rebate Program

 Fair Share Coalition Rebate Program

 CSA Benefits and Concerns: Consumer, Farmer and

Insurance Company Perspectives

 CSA Demographics

 Worksite Wellness Research

 Research on Impacts of Vegetable Consumption  Q&A

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Who are you?

 CSA Farmer or Farmer looking to offer a CSA  Insurance Company Representative

 Owner or manager of a company  Involved in food system work

 A CSA member  Healthcare worker

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 Name

 Where you work / What you do  Why did this session interest you?

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The Box

 Baby Kale  Microgreens  Hakurei turnips  Golden Beets  Carrots  Fingerling Potatoes  Shallots

 Red Kuri Squash  Fennel

 Garlic

 Are any of these items unfamiliar to you?  Would you be willing to try everything in

this box?

 Are there any items in this box that you

know you don’t like?

 If you received a box with a similar variety

of produce each week, do you anticipate having any waste?

 Can you think of anything that could be

done to help you figure out how to use the contents of this box?

 What might be some barriers to you

signing up for a box like this in the first place?

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You Choose

Carrots Butternut Squash Potatoes Acorn Squash Baby spinach Buttercup Squash Mixed greens Spaghetti Squash Lacinato Kale Shallots

Turnips Golden Beets Radishes Red Beets Garlic Fennel

Red Onions Brussels Sprouts Yellow Onions Parsnips

 If you had a running balance at the

Farmer’s Market stand offering these crops, which items would you buy?

 Would you be inclined to try new

items or stick with what you know?

 Would you experience issues

knowing what to do with the produce you bring home?

 Do you anticipate having waste from

what you buy?

 What benefits might you experience

from being able to choose your vegetables?

 What drawbacks do you see to

choosing your own verses picking up a pre-selected box?

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Luther College CSA Rebate Program

 Background  History

 Program Design

 Funding and Coordination  Participation and Outcomes

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Background about Luther

 Small liberal arts college in NE Iowa  2500 students

 ~ 525 FTE employees

 Strong sustainability initiatives at the college

 Student Gardens  Edible Landscapes

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Background about Decorah, IA

 6000 residents (not including the college)  Located in the Driftless Region

 Average farm size in the county is two-thirds of the state

average

 Many small, diverse farms  Unique food culture

 Thriving Coop and many restaurants sourcing local  Food Hub

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History of Luther CSA Program -

2012

 2012 – Proposal to Wellness Director for funding to support

CSA Program

 Pilot Program Funded

 50% of the cost of a share for .75 FTE or greater employees  2 book discussions & 2 cooking classes required for

reimbursement

 Two week sign-up period

 37 households (representing 46 employees) purchased

shares

 49% had never before subscribed to a CSA  54% chose a market share

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History of Luther CSA Program -

2013

 Created plan for an expanded program in 2013  Rebate: 50% (up to $100)

Education events: 2 required

 Sought to diversity funding stream:

 Proposal put before the college’s Health Care Council for $5,000.

Funded.

 Wellness and Sustainability each contributed $2500  Sustainability – Intern, food education events

 Goal: 100 participating households  Actual: 97 households

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History of Luther CSA Program -

2014

 2014 – Funding secured from Wellness, Sustainability and

Health Care Fund

 Health Care Fund increased commitment to $7500

 Rebate: 50% (up to $100)  Education events: 2 required  Goal: 150 households

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CSA Reimbursement Program

Design

 .75 FTE + Faculty/Staff eligible

 50% reimbursement for CSA share (up to $100)  Participants choose their CSA share

 Sign up with farm and pay farm directly by May 1st

 Complete CSA Reimbursement Program Form on Luther website  Attend 2 required food education events

 Send receipt and completed payment voucher to Sustainability

Office

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CSA Options

 Traditional Share (weekly or biweekly): $165 - $660  Market Share: $150 - $350  Garden Membership: $150 - $350  Winter Share (November/December) $160 - $220

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Food Education Events

* = kid friendly

Farm Work Days

 Patchwork Green Garlic Scape Work

Day*

 Strawberry Picking at Wolds*  Patchwork Green Harvest Day*

Book Discussions

 "Food Matters" by Mark Bittman  "Cooked" by Michael Pollan

Tours

 Oneota Coop Tour- Local Food Focus*  Sweet Earth Farm*

 Campus Edible Landscapes*  Annie's Gardens and Greens*  Patchwork Green PFI Field Day*  Patchwork Green Farm*

 Campus Edible Landscapes*

Cooking Classes

 Whole Food Smoothies*  Pressure Cooking

 What’s In Your Food?

 Kitchen Tools and How to Use Them  Spring Rolls*

 Grilling Vegetables  Presto! Pesto

 Cooking with kids*  Sourdough Bread

 Homemade Tortillas/Creative Burritos  Hummus and other Bean Dips*

 Stir-Frying

 Freezing Vegetables  Knife Sharpening

 Roasted Root Vegetables

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Funding and Coordination

 Year 1 (2012) – High program costs because of four required

food education events and local lunches. 50% reimbursement.

 Some reimbursements $300, others $75.  Not a sustainable model.

 Year 2 (2013) – More participants = higher reimbursement

costs, lower program costs due to lessened requirements. 50% reimbursement (limit $100)

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Funding and Coordination

 Wellness Department

 Pilot year (year 1) reimbursements

 $2500 annual commitment to reimbursements

 Sustainability Office

 Educational programming + student intern every year  $2500 annual commitment to reimbursements

 Health Care Fund

 Year 1: $0

 Year 2: $5000 (actual: $3812)  Year 3: $7500 (actual: $5497)

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Funding Trends

40% 60% 22% 33% 45% 20% 36% 44% 0%

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Key Players

 Health Care Council – Funding

 Wellness – Funding and HRA information

 Sustainability – Funding, staff, student intern, program

coordination, communication with farmers, promotion, record-keeping, food education event logistics, grower development

 CSA Farmers – Quality CSA options for our employers  Finance Office – Issue reimbursements

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Participation and Outcomes - 2012

 37 participating households / 46 employees  Survey results (64% response)

 70% unlikely to purchase a share without financial incentive  Participants enjoyed food education events

 70% ate more vegetables / 26% maybe

 100% saw program as valuable and would participate again  Benefits from the program:

 Connections to faculty/staff (42%)  Access to fresh, local food (70%)

 Connections to local producers (70%)  Regular supply of fresh vegetables (65%)  Learning opportunities (42%)

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Participation and Outcomes - 2013

 97 participating households / 117 employees  97% retention from 2012

 44% first time CSA members

 61% purchased market shares / 39% traditional shares  Survey results (52% response)

 74% ate more vegetables / 18% maybe

 82% would participate again / 18% said maybe  Enjoyed range of food education events

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Participation and Outcomes – 2014

 109 participating households / 125 employees  26.3% of employees participating

 Nearly 300% growth from year 1

 Split between faculty and staff mirrors the demographic at

Luther: 64% staff / 36% faculty (same as in 2013)

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Participation Trends

26%

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Participate again in 2015?

91% Yes

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Financial Incentive Important?

95% Yes

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Servings of vegetables eaten

during CSA season

0-1 servings: 3%

2-3 servings: 47%

4-5 servings: 39%

5+ servings: 11%

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As a result of this program, veggie

consumption…

Increased: 89%

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As a result of this program, the

amount we cooked at home…

Increased: 45%

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Primary reasons for participation

Affordable access to fresh, local food

Regular supply high quality, fresh

vegetables

Opportunity to support local

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Recommend to other employers?

97% Yes

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Top reasons for recommending

Investment in employee health may save on

long-term health care costs (52%)

Positive local economic impacts (38%)

Boosts employee morale (5%)

Creates community amongst employees

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Community Impacts

Increase in CSA farms

Increase in number of CSAs offered by preexisting

CSA farms

Employees with market shares spending

frequently market more often and spending more

money when they go

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Fair Share Coalition /

Madison Insurance Companies

 Three insurance companies work with the Fair Share Coalition’s CSA

Farmers to offer CSA rebates to their customers

 FSC screens the list of participating farms

 FSC matches businesses with farms that might be a good fit  Rebates reduce cost of share by up to 40%

 Promoted by insurance companies, individual policyholders sign up  Rebate: $100 individuals / $200 families

 Some farms allow installments throughout the season  Some employers do payroll deductions

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Barriers to Participation - FSC

 High up front cost

 Learning how to utilize the share

 People not appreciating the wide variety of vegetables or not

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Economic Impact - FSC

 From 2005 – 2010 roughly $3,049,000 of rebates were issued to

policyholders by two of the three insurance companies providing rebates. This represents 20,4000 shares

 Estimated total value of CSA shares during that time period was

$14.2 million

 Rebates represent 21% of shares purchased in the area over a

six year period

 2012 study of two insurance companies

 Distributed $641,000 of rebates to 3,768 participants

 Lots of money going to support local, small-scale farms

 Greater impact than subsidizing gym memberships to national

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Community Impacts - FSC

 From 2005-2010 number of Fair Share Coalition CSA farms

grew from 16 to 42

 Total number of shares offered through these farms went

from 2,000 to 9,000

 Program started with one insurance company, two farms and

96 policyholders and has grown to three insurance companies and over 50 farms

 Farmers spend less time marketing and can focus on growing

good food

 35% increase in CSA participation in the Madison area can

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Farmer Concerns about CSA

Rebates

 Customers receiving rebates may be less committed to the

ideals of CSA and less understanding of the shared risk component

 Insurance companies may stop offering shares which would

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Farmer Opportunities with CSA

Rebate

 Grow the number of CSA shares offered

 Educate consumers about shared risk model, sustainable

agriculture, community-building and environmental stewardship

 CSA rebate programs usher in new clientele

 Ability to sign up many members at once (Fair Share

Coalition CSA Fair)

 Potential to sell out of shares  Less time marketing

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Concerns for Entity Issuing Rebate

 Difficult to measure health impacts of CSA rebate programs  Hard to quantify potential long-term health savings stemming

from increased fruit and vegetable consumption

 Is there a benefit stemming from the up front cost?  Extra staff time to administer the program

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Benefits for Entity Issuing Rebate

 Increased customer satisfaction

 Increased feelings of goodwill towards insurance company

or employer

 Opportunity for community-building

 Helping to boost local economy while improving employee

access to vegetables

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Concerns for CSA Customer

 Unfamiliarity with produce items  Lack of time to cook

 Lack of creativity in the kitchen

 Cash flow issues – cannot afford to pay for entire share up

front

 Schedule doesn’t align with CSA pick-up schedule  No time for food education events

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Benefits for CSA Customer

 Easier access to fresh vegetables

 Subsidy to purchase local vegetables  Improved health

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CSA Demographics

 Arizona study (115 participants)

 Average age: 42  80.4% female  95.2% white

 72.1% incomes over $60,000

 88.5% have completed bachelors, masters or doctoral work  65.7% increased veggie consumption

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CSA Demographics

 Maryland Study (129 participants)

 92.2% white  85.3% female

 98.2% college educated  80.5% between 30-55

 53.9% incomes greater than $70,000  Average membership: 1.86 years

 22.5% of members have persisted more than 2 years  31.4% vegetarian

 92% wasted food from their share at some point during the

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Worksite Wellness Research

 Employees spend one-third of waking hours at work  Employers pay 30% of national health care bill

 Workplace programs effective because they can go through

preexisting communication channels

 Good wellness programs offer a variety of options to raise

awareness, reinforce positive behavior and lifestyle change and address environmental factors.

 Reduce healthcare costs, improve health and fitness, reduce

absenteeism, increase job responsibility and enhance self-responsibility

 Small incentives can work to incent positive health behaviors

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Worksite Wellness Research

 Higher cash incentive leads to a greater response to the

incentive

 Higher cash incentives may be required in order to incent

the sorts of deeper behavior (increasing fruit and vegetable intake) and environmental change that will lead to lower

long-term healthcare spending.

 Important that wellness incentives are available to low

income employees, who may benefit most from such programs.

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Worksite Wellness - ROI

 Tough to measure!

 $3.48 per dollar spent on wellness initiatives

 Medical costs fell $3.27 for every dollar spent on wellness

programming

 Savings of $2.73 in absenteeism costs for every dollar spent  Savings of $1.50 for every dollar spent

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Worksite Wellness – Cost of

Unhealthy Employees

 High cholesterol costs $370/year (Dupont)

 Between $1000 and $2000 more is spent per obese

employee, with an extra $2500 spent on employees with high cholesterol and $3300 on high blood glucose

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Impacts of Fruit and Vegetable

Consumption

 Decrease risks for depression, cardiovascular disease,

obesity and other medical conditions.

 Long-term benefits

 16% of adults will experience depression. Increased fruits

and vegetables can reduce risk of depression by 15%

 27% decrease in risk of stroke and 42% lower stroke

mortality rate

 25% lower chance of death by cancer

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Discussion

 Do you this this is a model that makes sense?

 Can you envision any partnerships that might be able to

come together to make something similar happen where you live/work?

 What do you see as the most significant barriers to getting a

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To learn more:

Maren Anne Beard

stumma01@luther.edu

563-387-1722

https://www.luther.edu/sustainability/campus/food/education /csa/

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